Breaking into Emergency Nursing

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Specializes in ICU, Onc, M/S Tele, Home Health.

I recently applied and was called back for two rounds of what I thought were successful interviews for a position in an ED at a hospital I respect and was very enthusiastic about working for. They seemed interested in my experience and called me in right away for my first interview. I have more than 3 years of med-surg and other specialty area experience (1 year of that in acute medicine, but none in actual critical care). The HR department mentioned they almost never call candidates back for second interviews and that this was probably a good sign. I sent a thank you note after my first interview with the manager and tried to show interest at both first and second interviews without seeming overly eager. After a lengthy waiting period (2-3 weeks) after the second interview, I called the hospital back for a follow up only to hear back 2-3 days later from the nurse recruiter that the department had passed on offering me a position because I don't have any ED experience and they need a better balance with a large number of new grad nurses hired. I'm disappointed that I didn't get this job but I'm interested in what I can do to become better prepared and be a stronger candidate in the future.

I realize Emergency Nursing is incredibly competitive and while I can understand needing a better balance to new grads, my question is: how do I bolster my background and become a stronger, more attractive emergency nursing candidate? I have considered becoming a volunteer EMT here in town, I imagine then I would receive ACLS and PALS training and get experience with the component of care leading up to the ED. I was also looking at the Emergency Nurse certification (CEN) to prepare me and reinforce my strong interest in Emergency Nursing but I know none of that is a guarantee and I'm not sure if getting my CEN will work in my favor or against me without an actual ED job/ED hours worked.

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Specializes in ED.

I am a new grad just hired to my local ED. I completed ACLS, PALS and NIMS before I applied. CEN and TNCC seem to be best taken when you have some experience under your belt, I was told to wait at least 8 months before trying for my TNCC. At least in my hospital, CEN is not required and you get minimal benefit from having it ($0.35 raise, whoop-dee-do). I believe I was hired because I completed my practicum in their ED, my preceptor and charge nurse spoke highly of me, I had some required certifications, and because I was energetic and enthusiastic. As with any job application, it always helps if you know somebody!!!

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ACLS/PALS are the mininum requirements to even apply at my work.. TNCC is highly recommended. You might keep in touch with the manager and let them know when you have your certs. Good luck

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It may be different now, but certs used to require a certain amout of time IN the specialty before you could take the exam...

You could consider a smaller hospital, in a smaller town if there's one nearby...they are usually more willing to accept someone who really wants to try another dept, and you could learn in a less intense ED, then move back to a larger, busier facility. Just an idea. I realize not everyone can up and commute, or even move, but it is an option... :) good luck :yeah:

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CEN is not recommended until you have a couple of years experience in the ED. TNCC and ENPC might be effective in helping to get you hired though.

I don't know what your current working situation is or if you are able to be flexible, but I got my position in the ED by first getting hired into the PRN float pool at the hospital where I currently work in the ED. I floated to the ICU and ED (as well as other floors), allowing management the opportunity to get to know that I was reliable and could handle the ED. It also gave me the advantage of being able to apply for an open position in the ED as an internal employee. Maybe you could try for a FT, PT, or PRN float pool position and then transition to the ED.

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It may be different now, but certs used to require a certain amout of time IN the specialty before you could take the exam...

You could consider a smaller hospital, in a smaller town if there's one nearby...they are usually more willing to accept someone who really wants to try another dept, and you could learn in a less intense ED, then move back to a larger, busier facility. Just an idea. I realize not everyone can up and commute, or even move, but it is an option... :) good luck :yeah:

A smaller hospital is a good idea. I like the environment of a relatively smaller hospital. It's easier to get to know management and them to know you, making networking easier. Just don't go so small that you will be the only RN in the ED at any point in the day or night...at least not for a couple of years.

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Yes-you need to have at least 2 years experience in the ER before you can take the CEN. Not saying that you couldn't pass it-but I think it would be very difficult to pass without ER experience. To me it doesn't make sense that you have to have the 2 years experience for certifications. I have to wait another year and a half to take my GI certification. My feeling is that if you have the knowledge you should be able to take the test!

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Yes-you need to have at least 2 years experience in the ER before you can take the CEN. Not saying that you couldn't pass it-but I think it would be very difficult to pass without ER experience. To me it doesn't make sense that you have to have the 2 years experience for certifications. I have to wait another year and a half to take my GI certification. My feeling is that if you have the knowledge you should be able to take the test!

Two years is recommended but not required.

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Specializes in ICU, Onc, M/S Tele, Home Health.

Thanks for the advice guys! It sounds like the CEN isn't such a good idea just yet but getting some of the advanced life support training in, perhaps as an EMT might be helpful. I'm going to look at the TNCC and ENPC certs as well. The float pool sounds great too, though most hospitals prefer someone with experience in say emergency nursing before they go pool in that department. Somewhat of a commute is an option but with gas prices being what they are I wouldn't want more than an hour commute to get to an ED.

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It definitely wouldn't hurt to get the CEN books and info, and be working on it- the knowledge can only be helpful during an interview. It also shows you're committed....even if you can't take the test, you can be getting ready :)

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Thanks for the advice guys! It sounds like the CEN isn't such a good idea just yet but getting some of the advanced life support training in, perhaps as an EMT might be helpful. I'm going to look at the TNCC and ENPC certs as well. The float pool sounds great too, though most hospitals prefer someone with experience in say emergency nursing before they go pool in that department. Somewhat of a commute is an option but with gas prices being what they are I wouldn't want more than an hour commute to get to an ED.

What you say about needing experience for the float pool is usually true, but the smaller hospitals will also be more likely overlook this as well. I wouldn't say you need to avoid larger hospitals because you never know what can happen, but the odds are better with the smaller ones. Just for a frame of reference, my hospital is less than 200 beds if you don't count OB and a small ortho floor which is only open for post-ops Mon-Fri, with a 21-29 bed ED (depending on if the fast-track side is open). I had only 6 months of nursing experience when they hired me. I would think you have more than enough nursing experience to qualify.

And I agree with getting the CEN books to study from in the meantime. Good luck!

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